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Psych 343 > End of life > Flashcards

End of life Flashcards

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1
Q

what is the medical model

A
  • doctors are trained to diagnose and treat problems with the body
  • receiving aggressive, ineffective treatments can reduce quality of life
  • individuals don’t like spending time in the hospital as it feels like they are nearing end of life
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2
Q

what is palliative care

A

specialized healthcare for people with serious illness that focuses on improving quality of life

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3
Q

what is hospice

A

healthcare that focuses on improving quality of life, reducing pain, and prioritizing comfort in the end of life

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4
Q

outcomes of hospice residents

A

more likely to receive pain treatments

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5
Q

outcomes of palliative home care

A

lower depression levels, less symptom distress, and reported better physical health and quality of life

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6
Q

palliative care - being at home

A
  • 3 quarters of Canadians say they want to die in their homes
    15% die at home; 60% die in the hospital
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7
Q

BC palliative care benefits

A

allow patients to receive palliative care at home rather than be admitted to the hospital (access to the same medical supplies, equipment, and drugs)

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8
Q

a good death - free from pain

A
  • having pain under control
  • having control of bladder, bowels
  • being able to breathe comfortably
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9
Q

a good death - surrounded by family and loved ones

A
  • spend time with children/family as much as you want
  • be touched and hugged by loved ones
  • say goodbye to loved ones
  • spend time with your spouse, partner
  • spend time with pets
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10
Q

a good death - autonomy and control

A
  • having control of the event
  • discuss your wishes for end of life with doctor/others
  • being able to feed oneself
  • die with dignity and respect
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11
Q

what is prognosis awareness

A

the extent to which the patient is aware of their terminal illness (short-term life expectancy)

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12
Q

hope in terms of health

A
  • hope is good (focus/belief in a future-orientated positive goal)
  • reframing to goal of high quality of life rather than goal of a cure
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13
Q

acceptance in terms of health

A
  • acceptance may affect some end-of-life care choices (less likely to have feeding tube in last week of life)
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14
Q

what is death anxiety

A

a sense of apprehension or fear at the thought of death or the process of dying

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15
Q

fear of death - intrapersonal

A

fear of impact on one’s body and psyche

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16
Q

fear of death - interpersonal

A

fear of impact on others and loss of social identity

17
Q

fear of death - transpersonal

A

fears about the afterlife and uncertainty

18
Q

religious and spirituality

A
  • religious faith can bring hope and relieve death anxiety
  • people with higher intrinsic religiosity express lower death anxiety
  • religious rituals can provide comfort in times of stress
19
Q

communicating death

A
  • Junior doctors often have to notify the family about someone’s death
  • stimulation-based training can help prepare doctors for real-world scenarios
20
Q

what is brain death (brain stem death)

A

irreversible brain damage causing the end of independent breathing

21
Q

organ donation

A
  • organs are donated from those who are brain-dead/living donors
  • basic understanding required for valid informed consent
    (can donate kidney/lobe of your liver)
22
Q

organ donation - opt-in vs opt-out

A
  • Canada/USA use opt-in model
  • Austria, France, Belgium, Wales, and Spain use opt-out model (presumed consent)
23
Q

what is the default effect

A

making an option a default increases the likelihood that such an option is chosen

24
Q

organ donation - mandatory approach

A

most organ donor organizations in Canada use a mandatory approach
- family members are asked to approve regardless of one’s organ donor registration status

25
Q

history of medically-assisted death

A
  • ancient Greeks/Romans supported voluntary death vs. prolonged agony
  • 1828 - first American law banning assisted suicide
  • 1997-2001 - legalized in early countries
  • 2008-present - more countries legalizing
26
Q

Medical assistance in dying (MAID) in Canada

A
  • legalized in 2016
  • voluntary euthanasia and physician-assisted suicide are available
  • have to be at least 18 years old and mentally competent
  • make voluntary requests for MAID
  • give informed consent
  • have a grievous and irremediable medical condition
27
Q

procedural safeguards in Canada (MAID)

A
  • request is assessed by 2 independent practitioners
  • sign a written request, witnessed by an independent witness
  • final consent must be provided immediately beforehand
28
Q

Psychiatric conditions (MAID)

A
  • in 2024, for psychiatric conditions (depression, personality disorders)
  • additional safeguards/protocols created via an expert review
29
Q

what is grief

A

the psychological reaction to the loss of a significant other

30
Q

what are common experiences of grief

A
  • desire to reunite
  • feeling of emptiness
  • depressive symptoms
31
Q

grief - timeline

A
  • timeline can vary for each individual
  • typically people experience a progressive decrease in psychological pain and re-commitment to life within 6 months
32
Q

what are the 5 stage model of grief

A
  1. denial - avoidance, confusion, fear
  2. anger - frustration, anxiety
  3. bargaining - struggling to find meaning
  4. depression - overwhelmed, hostility
  5. acceptance - exploring options
    - individuals may experience in different order or skip stages
33
Q

what is dual process model of grief

A
  • two concurrent stressors:
    1. loss orientation - grief work
    2. restoration orientation - attending to life changes
  • people oscillate between in two stressors
34
Q

what is complicated grief

A

unusually severe and prolonged grief that impairs function in important domains

35
Q

what is prolonged grief

A
  • a part of the DSM 5 (affects 2-3% of the population worldwide)
  • more likely after loss of child, spouse and after sudden/violent death
36
Q

ritual and cultural practices

A
  • death can create a sense of chaos and loss of control
  • rituals can help restore a sense of control and normalcy
37
Q

what is disenfranchised grief

A

grief experienced by those who incur a loss that is not publicly mourned or socially supported/validated

38
Q

disenfranchised grief - miscarriage

A
  • women report experiencing a lack of empathy and insensitive comments
  • families report that their loss is unacknowledged
  • “a vast silence” surrounding miscarriage
39
Q

disenfranchised grief - pet bereavement

A
  • an implicit norm that bonds between people and pets
  • self-reported closeness to pets can be equal to closeness like mother/S.O./best friend

Psych 343 (5 decks)

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